Because of the added complexity, Twersky and other authorities recommend outsourcing the billing for treating OSA patients. “A lot of companies will want to sell you a billing program, but because the documentation is so overwhelming, it’s just better to find a reputable billing agency. You have to actually fight the insurance company. It requires about six ‘no’s’ before you get a ‘yes.’”
Twersky also warns that dentists entering the field of dental sleep medicine should be aware of the need for interdisciplinary coordination. “It’s the first time in the dental industry that the dentist is not the quarterback. The dentist is part of the team, and the quarterback is the MD.” The need for a team approach may require an adjustment in thinking. Nonetheless, those who adjust can significantly expand their revenue, Twersky believes.
If Jeffrey S. Rouse, DDS, an expert in “sleep prosthodontics” who practices in San Antonio, Texas, is correct, there’s also a lot more work to be done relating to airway disorders beyond those manifesting during sleep. “Sleep is just one part of it,” Rouse says. “Airway problems are progressive. It’s an airway system, and problems are magnified when the person is sleeping. But all day long you have to manage the airway.” Rouse argues that dentists can and should spot intraoral signs of airway issues at their inception, rather than when they have developed into disease states.
“We focus on apnea because it’s easy to measure,” he says, “but our scope is really too limited.” It’s not just middle-aged men who are affected; children are being damaged quite dramatically by airway problems,17 he contends. Young, fit females are vulnerable to Upper Airway Resistance Syndrome.18 “The true number of people who are impacted by airway and sleep issues is staggering.”
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